Cc ©
Date : 07/25/96
Page : 1

UFK ASSASSINATION SYSTEM
IDENTIFICATION FORM

AGENCY INFORMATION

AGENCY : INSCOM/CSF
RECORD NUMBER : 194-10013-10141
RECORDS SERIES : DOD-AFFILIATED PERSONNEL AND INCIDENT INVESTIGATIONS
AGENCY FILE NUMBER : .Z2F000003W - PAGES 1183-1184

DOCUMENT INFORMATION

ORIGINATOR : USA
FROM :
TO :
TITLE : SWORN STATEMENT
DATE : 10/03/82
PAGES : 2
SUBJECTS : SLOVODA, VLADIMIR

WHITE, JOSEPH TIMOTHY
.[ RESTRICTED ]
AFFIDAVIT
DOCUMENT TYPE : PAPER, TEXTUAL DOCUMENT
CLASSIFICATION : UNCLASSIFIED
RESTRICTIONS :. 3 '
CURRENT STATUS : RELEASED WITH DELETIONS
DATE OF LAST REVIEW : 03/20/95

OPENING CRITERIA :
COMMENTS - :

NW 88613 Doctd:34531352 Page 1

|

SWORN STAT EMENT

[os of The Deputy pli Qf Staff for Personnel.
COLY MELA LOUSSOGLE 3 OTe LZ
LAST NAME, FIRST NAME, MIDOLE NAME SOCIAL SECURITY NUMBER, GRADE/STATUS A
La SrEle AEM CANE : Cor |
Ble MAREWCOD DL COLUM EIA flo é520/
”~—COPG
NEN Y D. Gea STB, 647 76-1070, CPLA, LEONE AT Be
MAPLEWOOD DP, COLUMBIA MISSO.RE AUSHOKIZE RLECEASE Or AEE
re PAUL F. £0 ZANO, 902' MI GROUP CON CEFENIVG = TOSELY FIULHY
WHITE, TO Me MORVAL cw Mn) WHITE FR (fA THER OF FOSEAM THoTA

ORGANIZATION OR ADDRESS

1, LEWOY  ONINEC__ GLAU TEL SANT TO MAKE THE FOLLOWING STATEMENT UNDER OATH
REMRT DA foRM 341, DATED 22 SEPTEMBER 1982, SUGUNNTEO BY
ware) CBD //// 11/6 6 ENO OF STRATE OEE JALECE OSS

1183

| Coys
OF BE RSC Oe,
CONTINUED.*”

ADDITIONAL PAGES MUST CONTAIN THE HEADING “STATEMENT OF ___ TAKEN AT _ DATED __' TH *
BOTTOM OF EACH ADDITIONAL PAGE MUST BEAR THE INITIALS OF THE PERSON MAKING THE STATEMENT AND
BE INITIALED AS “PAGE___OF__PAGES."" WHEN ADDITIONAL PAGES ARE UTILIZED, THE BACK OF PAGE ! WILL

| BE LINED OUT, AND THE STATEMENT WILL BE CONCLUDED ON THE REVERSE SIDE OF ANOTHER COPY OF THIS FORN.

DA: FOP 2Q23 — surenseoss 04 ron sone, 1 san se, wich wit ex USED.

NW 60613 Docid:34531352 Page 2

t ‘STATEMENT (Continued)

q

HAVE READ

[MENT WHICH BEGINS ON PAGE t AND ENDS ON PAGE Ze. . | FULLY UNDERSTAND THE CONTENTS OF THE ENTIRE STATEMENT
MADE BY ME. THE STATEMENT IS TRUE. | HAVE INITIALEO ALL CORRECTIONS AND HAVE INITIALED THE BOTTOM OF EACH PAGE
CONTAINING THE STATEMENT. | HAVE MACE THIS STATEMENT FREELY WITHO
OF PUNISHMENT, AND WITHOUT COERCION, UNLAWFUL INFLUENCE, OR U

7 St 3
WITNESSES: (Signature of Person Making Statement)

Subscribed ond ewern to before me, o persen euthorized by |.w
te administer oaths, this “3 dey AOCTDELL . wA2_
Le, CSSOH

at
NORGANIZATION OR AOORESS 2 BAe
; 7 7 LY. of 2 am q

RAUL J. LOZANO, 902d MI Group
(Typed Name of Person Adminiatering Oath)
ORGANIZATION OR ADDRESS Article 136(b), UCMJ
}

(Authority To Administer Cathe)

®U.S. G.P.O. 1980- OOP IPARTT

NW 60613 Docid:34531352 Page 3

